Trauma Sensitive Yoga (TSY) is an evidence based treatment for complex trauma and post-traumatic stress disorder. It is used with children, youth and adults in Iowa and throughout the world. Some participants engage with Trauma Sensitive Yoga as part of a holistic approach to healing from trauma, a complement to their ongoing counseling. And others participate as an extension of their yoga practice. Anyone can participate, regardless of their level of physical abilities and experience. The goal is healing.

Although Trauma Sensitive Yoga employs physical forms and movements, the emphasis is not on the external expression or appearance (i.e. doing it “right”), or receiving the approval of an external authority. Rather, the focus is on the internal experience of the participant. This shift in orientation, from the external to the internal, is a key attribute of Trauma Sensitive Yoga as a complementary treatment for complex trauma, and has been empirically validated. With this approach, the power resides within the individual, not the facilitator. (Although it is important to practice with a qualified facilitator.)

Sensitive Techniques: Trauma Sensitive Yoga participants are invited to notice and feel sensations within their body throughout the practice. Participants are then encouraged to make choices about what they do and how they move with their body based on what they sense. This supports participants to investigate what choice feels supportive for them, taking cues from their own individual experience.

Inquiry-Based Exploration: The approach applies choice and body-centered self-awareness to support a recovery process, a gentle intervention that initiates healing through people regaining a relationship with the present moment and their body. The language used throughout a yoga session is invitational and encourages curiosity to explore what one might feel in different parts of their body based on the form they are choosing to take.

The goal of Trauma Sensitive Yoga is to befriend, reconnect with and feel empowered in your body. In a safe and predictable environment, you are invited to notice sensations, experiment with movement and breathing, and practice making choices about what is right for you. Further, by focusing on the felt sense of the body to inform choice- making, Trauma Sensitive Yoga enables participants to restore their connection of mind and body and cultivate a sense of agency that is compromised as a result of trauma.

“Is Trauma Senstive Yoga right for me?” If you’re asking the question, you may be a good candidate for this treatment method. Consult with your counselor, or register for one of our classes at the Des Moines Pastoral Counseling Center. More information here: https://dmpcc.org/classes-events/

Kathe Irvine, L.I.S.W., is a licensed independent social worker. She earned her undergraduate degree in sociology and women’s studies from the University of Northern Iowa and her Master of Social Work degree from the University of Iowa. Kathe provides counseling and psychotherapy to individuals as well as couples and families. She is trained trauma sensitive yoga provider. Kathe has a special interest in providing holistic care to resolve issues of grief, trauma, life transitions, divorce, anxiety and depression. Kathe is a member of the National Association of Social Workers.

We’ve survived the holidays. We made it through January 1. 2018 has arrived. Each new year holds possibilities that life will be somehow different than in the past.

We now face the blank slate between New Year’s Day and Memorial Day. Most of nature is dormant. The excitement of the holidays is over, and life has resumed at a less frenetic pace. We may feel bored, unusually tired, or just a bit out of sorts. Some people made epic New Year’s resolutions that seem daunting as life or second thoughts get in the way or perhaps they’ve lost their appeal. The shine has worn off. The grand letdown happens every year. We may feel a sense of dread as we envision weather-related confinement.

Despite the long five-month stretch, each month has moments of distinction that help ease the transition. January and February are perhaps the most desolate, but the two months combined are only nine weeks, and the time passes quickly. March brings the beginning of Daylight Savings Time and the first day of Spring. Trees and plants bud in April and herald the welcome return of songbirds. May shows off huge blooms of peonies—pink, white, and deep red—and fills the air with the fragrant blossoms of lilacs. Life is stretching itself awake after a long winter snooze. When I look at the stretch and remember what each month offers, the time passes easier as I’m less restless, less anxious, and less depressed.

The transition from winter into spring is a time for refreshing, recuperating, rejuvenating and transforming. On the surface, everything is drab, brown, and gray. Underneath, however, new life is resting until the warm rains of Spring signal that it’s time to come forth. We may look out our windows and see drifts of sparkling snow and icy sidewalks. Or, we may have escaped to a warm climate. We may have plenty to do to ward off cabin fever. Or, we may wonder what we can do to occupy the time. We have a stellar opportunity to create new practices and habits that serve us, an ideal time to ask the deeper questions about what matters most and how we want our lives to unfold over the next twelve months. What is calling us?

I’ve made plans to improve two big areas of my life in 2018, my health and my writing. There is so much more I want to accomplish, but I take care not to overwhelm myself and invite shutdown.

Early in 2017, I created a list of forty-eight life questions to explore. I spend time contemplating the state of my life now, and what I want from life moving forward. I then delve into identifying the steps to turn each into a manageable goal with realistic action steps. What follows are variations of some of the questions.

What do I want my attitude to be in 2018? This is possibly the most important and the most difficult question to ask. Attitude is one area of my life where I have control. How I approach life’s drawbacks can mean the difference between peace and serenity, and hopelessness and despair. I adjust my attitude by getting as much information about my situation as possible, journaling, and talking to people I trust.

What do I want to affirm in 2018? I reflect on 2017 and think about epiphanies and insights that brought focus and clarity to my life. I’m learning to ask for help and to be vulnerable with the people in my life who love and care about me. In the process, I’m affirming that I’m worth the time and attention of other people.

How do I want to spend my time in 2018? Every year has 525,600 minutes, 1,440 minutes per day. Those minutes tick away whether I notice them, or they pass by without getting my attention. I want to engage in activities that are important to me, that bring me joy and peace and evoke a sense of awe and wonder. I want to invite experiences into my life that transform me emotionally and spiritually. I want to invite more play and recreation into my life.

Who are the people I want in my life? I look at the relationships in my life and determine whether they support or cause me pain. Relationships are complex, and I can’t always create a desirable distance between another person and me. I take care to ensure that I am safe before making drastic changes to my relationships. I consider such factors as how much the relationship means to me and how I can deal with the situation in ways that maintain dignity for everyone involved.

What do I want to do differently in 2018? I turn my attention to my intentions, goals, and dreams and choose with care activities that nurture me. I map out doable steps to help me attain my definition of success in my endeavors.

The winter months with the shortened amount of daylight can put the strongest emotional resolve to the test. Dark days and cloudy skies can contribute to a host of emotional issues. Living with emotional upheaval or pain and chronic issues can mean just getting through the day is progress. I try to remember that, back on December 21, the beginning of Winter and the shortest day of the year, meant that subsequent days would become increasingly longer and that sunlight in abundance would return. I know that the darkness and time of dormancy are temporary.

We can look forward to this time of year with a spirit of appreciating and celebrating the seasonal changes. We can welcome each change as an unfolding of the ever-flowing energy of life. We can participate in the transitions and match the rhythm of nature with our own. May 2018 be a year of renewal for you.

Billie Wade is a gregarious introvert whose primary interests are writing, lifelong learning, personal development, and how we all are affected by life’s vagaries. Issues facing black people, women, the LGBTQ community, and aging adults are of particular concern to her. She enjoys open-hearted dialogue with diverse people. The opinions expressed here are her own.

Living with cancer or a chronic illness is challenging at the best of times, but especially during the winter holidays. Although it may be a joyful time of year, when we are ill we may feel too tired, depressed or anxious to celebrate. We may also feel overwhelmed with expectations (ours or others’) to do everything we’ve always done. We may feel obligated to be happy and cheerful while feeling sad and scared inside. How can we celebrate a meaningful holiday season while dealing with illness?

Holidays are “holy” days – days of holiness and days of wholeness, days to which we bring our whole selves. The words “holiness” and “wholeness” are connected in many languages, as are the words “wholeness” and “wellness.” Holiness means bringing our whole selves to whatever we are doing, from whatever state of wellness we are in at present. If we need to receive more than give at a particular time, then wholeness means acknowledging that and making decisions and plans that reflect our needs to receive as well as give.

The winter holidays take place at the solstice, when the days have reached their shortest point and light begins to increase. One meaning of these holidays is to celebrate light in darkness, the turn from the darkest days toward ever increasing light. This is expressed in different ways in different religious traditions – by lighting candles, celebrating the solstice or the newness of birth. These holidays bring attention to the coexistence of both light and darkness. Making room for that both/and thinking can help us celebrate meaningful holidays while dealing with illness. Maybe we can be both tired and grateful for the love of family. Maybe we can participate in a holiday celebration and also attend to needs for rest and quiet. By being mindful of our needs and experiences in each moment, we will be better able to determine how we want to participate in holiday celebrations.

As you consider how you want to celebrate this year, it is helpful to think about what these holidays mean to you. You may want to reflect on some or all of the following questions:

What is special about this holiday for you?

What are its most important aspects?

What family or personal traditions are most meaningful to you in this holiday?

What do you need from this holiday this year?

What balance would you like to achieve between giving and receiving? What would you like to give? What would you like to receive?

How might you bring holiness into this holiday?

Holidays can be stressful, even when they are very meaningful. This can be particularly true when you or a loved one is dealing with cancer or another chronic illness. When we are depressed or anxious, the holidays can be a time of dread, especially when we have high expectations that we feel unable to meet. Allow time for rest and reflection as well as time to be with whatever painful feelings arise during this time. Take extra care to find a supportive person with whom to share these feelings. Try to cultivate a both/and perspective: I can feel sad AND loving at the same time; I may be anxious AND I can still enjoy this holiday music/event/tradition, etc. And avoid overdoing – overspending, overexerting, over-expecting.

Here are some things to consider as the holidays approach:

Focus on the most meaningful aspects and traditions of the holiday. Develop your own rituals, such as a gratitude practice or sharing meaningful stories and memories, to celebrate these moments.

Don’t try to make this holiday season exactly the same in previous years – adapt your celebration to fit your current health situation.

Use this opportunity to develop more meaningful and less stressful traditions.

Rest even more than usual – emotional stress is exhausting.

This year, learn to receive. Connect to spiritual teachings about receiving within your tradition. Allow others the joy of giving to you.

With attention to the holiness of the holidays as well as our own wholeness and wellness, we can create meaningful holiday celebrations, in spite of illness.

Christine Dietz is a licensed independent social worker, spiritual director and Reiki Master. She is the Center’s Director of Clinical Training. She received her M.S.W. from the University of Iowa and her Ph.D. in Sociology from the State University of New York at Buffalo. She is a graduate of the Lev Shomea Training Program for Spiritual Direction in the Jewish Tradition. Christine’s focus in counseling is on helping people reconnect to their innate wholeness and renew their sense of hope and possibility. She works with people experiencing anxiety, depression, OCD, trauma, life transitions, chronic illness, grief and loss, and relationship issues. She also offers individual and group spiritual direction to people from all faith traditions. She is a member of the National Association of Social Workers and Spiritual Directors International.

(September 2017) Hi All! For our blog topic this month, I want to open a discussion about a tough topic. September is National Suicide Prevention Awareness Month, and while this is an important topic for us all to consider, it is especially important to open a dialogue with boys and men about suicide. For various reasons, we know from the Center for Disease and Control and Prevention (CDC) that girls and women are far more likely (3x) to ATTEMPT suicide during the course of their lives; however, we also know that boys and men are far more likely to COMPLETE suicide (3.5-4x) than girls and women.

Furthermore, we know from a recent study at the University of Iowa, that farmers have been particularly vulnerable to the lure of suicide since the farm crisis of the 80s and continuing today. I’d like to give just a few more statistics to drive home how important this discussion really is to we Iowans. Suicide is the 9th leading cause of death overall, here in Iowa, and is the 2nd leading cause of death among Iowans age 15-34. In my clinical practice, I’ve also seen a deeply troubling trend toward more suicidality among our teenagers.

The above statistics make a chill run down my spine, and are very sobering. They also highlight some opportunities for all of us, male and female, to examine how we can play a part in changing the lives those statistics represent. It is within all our power to educate ourselves on risk factors, signs of risk for suicide, and ways to help ourselves and/or others who face thoughts of suicide. To that end, I’d like to share some thoughts and resources in the hopes they may prove helpful to you.

No one is immune to the effects of suicide. While I’ve shared above some demographic information about particular risks, anyone can be struggling!

Most people who experience suicidal thoughts are in great pain and/or have suffered great loss, such as loss of job, romantic partnership, respect, or legal freedoms. To view people who struggle with suicidal thoughts and behaviors as “weak” downplays their pain, and ignores that we all could find ourselves in their shoes.

People who have supportive relationships and communities, including religious and spiritual communities, are less likely to suicide. They are also more likely to receive treatment for underlying physical and mental health concerns that put them at risk for suicide.

When in doubt, don’t hesitate to talk about suicide! There is no evidence that asking someone or talking about suicide “puts the idea in their head.” Since males can often receive messages about being the “strong silent type”, we especially need others to check in with us about suicide so we can feel ok to open up. Even if someone is shocked or mad on the surface because you asked, doesn’t mean you were wrong to ask out of care and concern.

Men are less likely to seek help for many health concerns, especially traditional mental health help. Don’t assume that anyone who may be struggling with suicidal thoughts is getting help, or that others know and are taking care of that person!

There are supports available. Whether for you or someone you know is struggling with suicidal thoughts, reaching out for help can be the most difficult and important thing. Resources for help can be found through the American Foundation for Suicide Prevention at: https://afsp.org/find-support/. You can also seek emergency assistance from a local hospital or 911 call, and non-emergency assistance from the Des Moines Pastoral Counseling Center at (515) 274-4006.

(November 2017) – The word “mindfulness” has become very much of a buzz word these days. It’s new, hip, totally the rage, and also 2,500 years old. Neuroscience is finally confirming what so many people have known for centuries from their own direct experience and practice, that mindfulness meditation can help you reduce stress and help keep your brain young.* Many of us are almost always in “doing” mode: the constant multi-tasking and busyness of life and glued to our smart phones as to not miss a text, meeting or notification. Add in job, family, and relationship stress…toxic stress can really take its toll on our minds and bodies. Meditation can seem like a pretty foreign topic, but it’s surprisingly and beautifully simple. Simple…. but not easy.

Mindfulness is a solution to our chaotic lives. It’s a way of waking up out of auto-pilot and taking back our innate, human ability to fully “be” in the moments of our lives, that can only be experienced directly in the “now”. Mindfulness is an ancient practice that has been introduced into secular settings like public schools, businesses like Google, Twitter and General Mills, hospitals, and even the military. According to the founder of the 37-year-old MBSR (Mindfulness Based Stress Reduction) program, Jon Kabat-Zinn: “Mindfulness is about being fully awake in our lives. It is about perceiving the exquisite vividness of each moment. We feel more alive. We also gain immediate access to our own powerful inner resources for insight, transformation, and healing.” Which, turns out to be much easier said than done. Here are a few tips if you’re interested in beginning a meditation practice:

Start Small: Know Your Why – If you don’t know why you want to start a meditation practice, you’ll never stick to it. Take a few moments to really ask yourself why you’re doing this. Maybe it’s because you want to be less reactive to your kids, show up more fully for your spouse, reduce stress, find more peace of mind, or you want to be kinder and gentler to yourself. Meditation can be difficult at times, and the payoffs don’t show themselves immediately. Knowing your why can keep you on track, even if you don’t feel like it – you remember the bigger reason of your commitment. Once you begin to feel the benefits, these moments help motivate you to keep going. Anyone has 5-10 minutes in their day – try a simple awareness of breathing meditation. One of my favorite meditation apps is called Insight Timer, plus it’s free!

Take One Bite: Mindful Eating – Eating is a wonderful opportunity to experience mindfulness since we do it multiple times per day. Eating has become so familiar that we hardly notice the explosion of flavors, textures, aromas and the simple, but powerful pleasure of taking in nourishment. Take back your lunch break – sit and Just. Eat. Don’t distract yourself with technology, driving, working at your computer, or even talking with someone. Start by sitting down with your meal and taking three mindful breaths before you take your first bite. Using your five senses, simply pay attention to the process of eating. When your mind wanders, note what’s on your mind and acknowledge that you were involved in another storyline, place or time. Then, bring your attention back to the present, using eating as the object of awareness. Can “just eating” be enough for you without trying to add in more stuff?

Take an MBSR™ class – Mindfulness Based Stress Reduction is a 37-year old program that has been proven to reduce symptoms of stress. The course is for adults who’ve never practiced meditation as well as seasoned practitioners. It’s intended to make the practice your own, incorporate it into your life, and support you in creating and maintaining a regular meditation practice. MBSR™ is designed to recognize and put to use our inner psychological resources to respond to toxic stress, increase stress hardiness, focus, creativity, regulate emotions, and allow a greater sense of self-care and well-being.

BIO:

Allison Peet, Mindfulness Instructor

Allison Peet is a qualified MBSR™ (Mindfulness Based Stress Reduction) Instructor trained at UMass Medical Center for Mindfulness, founded by Jon Kabat-Zinn, PhD. She is trained through Mindful Schools and teaches mindfulness to youth, K-12. She’s completed 21 full days of silent meditation retreats to date, has a daily practice, and is currently working toward a therapeutic yoga teacher 200-hour certification. Allison has a personal path of living and working with chronic stress and anxiety which is why she started her own business in 2015, From Within Wellness, LLC, to benefit others. She is committed to creating a more mindful community by helping people develop practical life skills in attentional strength, present moment awareness, self-compassion, and stress resiliency.

“A study by Dr. Eileen Luders at UCLA School of Medicine, published in Neurolmage, shows that long-term mindfulness practitioners have greater brain volume, stronger neural connections, and less atrophy than non-practitioners. This suggests mindfulness may keep brains young and even help prevent dementia.” Vol 45, Issue 3, Apil 15, 2009: Pg 672-678

Mindfulness Reduces Stress (2010)

A study conducted by Britta Holzel at Massachusetts General Hospital, and published in Social Cognitive and Affective Neroscience, finds that mindfulness-based stress reduction can lead to structural changes in the amygdala, a brain structure that plays a crucial role in stress responses.” Vol. 5, Issue 1: Pg 11-17

(June 2017) People cope with stress and emotional pain in many ways: exercise, alcohol, eating chocolate, meditation, using drugs, therapy, self-injury. All of these can be effective coping mechanisms in the short-term; not all, however, are effective in the long-term.

Self-injury, also called deliberate self-harm, is the act of intentionally hurting one’s body for purposes that are not socially recognized, and without suicidal intent. The most common form is cutting, although it can take many forms. It usually starts early in life, around adolescence. Studies have found that 12-24 percent of young adults have self-injured, and that around 6 – 8 percent chronically self-injure.

The reasons for self-injuring are diverse, but share a common theme of providing a release or relief for overwhelming negative emotion or emotional pressure. Sometimes, it is a way of feeling physical pain in the face of overwhelming emotional pain, or as a way to “feel something” when an individual feels emotionally numb. It can also be used as a means of coping with anxiety.

Self-injury is often misunderstood as suicidal behavior. In fact, individuals who self-injure are doing so in order to cope with overwhelming negative feelings, and most studies find that self-injury is often used as means of avoiding suicide. Self-injury is also often misunderstood by family and friends as a means of getting attention, or as “manipulative” behavior. While attention is often a result of an individual injuring themselves, this is usually an unintended outcome – most people who self-injure do so in private, make great attempts to hide their injuries, and often feel shame or guilt about the injurious behavior.

Effective treatment of chronic self-injury ideally involves working with a therapist to address not only the cutting or injurious behavior, but also the underlying triggers and causes. In addition, it can be very helpful for family members to participate in the therapy, in order to educate themselves about how to best support their loved one through the recovery process.

To learn more about self-injury, an excellent resource is the Cornell Research Program on Self-injury and Recovery. They provide information for individuals who self-injure, as well as family, friends, and youth serving professionals. They can be found online at http://www.selfinjury.bctr.cornell.edu.

*

Alison Li is one of 26 clinicians at the Des Moines Pastoral Counseling Center. One of her treatment specialties is self-injury. To make an appointment with her, or another counselor at the Center, call 515-270-4006. The Center’s mission is to bring hope, healing and understanding to people of all ages through mental health counseling, psychiatry and education. For more information please visit our website: www.dmpcc.org or find us on Facebook.

My mother, Winifred (Winnie) Grace Hayes, died April 24, 2017, after a three year dance with pancreatic cancer.

We all face death, dying, grief, and the support necessary to endure at various points in our lives. I have spent a good bit of my career walking with and counseling folks who have lost a loved one. As I recently mentioned to a colleague here at the Center, when it comes to grief there’s a big difference between the theoretical and experiential. As one of my favorite writers, Flannery O’Connor, put it in one of her letters (collected in The Habit of Being), “pity the one who loves what death can touch.”

It’s disorienting. As much as I like my new job, I find myself regularly distracted as I think of my Mom—or my Dad who is now navigating life without his wife of 59 years. I worry. You reach out to pick up the phone and then realize it won’t be answered. It hurts.

One of the great benefits about working here at the Center is that I’m surrounded by folks whose job is to be sensitive and empathetic. Their concern is sincere as they ask me how I’m doing. Like many people in our lives, my perfunctory response is that “I’m fine.” Usually I am. When I’m not, it’s nice to be able to open up a bit. One of those colleagues gave me a bookmark which we hand out to those who have lost someone. It captures this quote from Helen Keller: “What we have once enjoyed we can never lose. All that we love deeply becomes part of us.”

We distribute or reference many books on grief here at the Center. Among the popular authors is James E. Miller, who just happened to live across the hall from Ellery Duke in grad school. Miller’s books are eminently practical. In his book, “How Will I Get Through the Holidays?” he enumerates 10 ways to cope:

Accept the likelihood of your pain.

Feel whatever it is you feel.

Express your emotions.

Plan ahead.

Take charge where you can.

Turn to others for support

Be gentle with yourself.

Find a way to remember.

Search out your blessings.

Do something for others.

Many who visit us for counseling and spiritual direction have been touched by death and grief. I am so grateful that they will find at the Center a place of hope and healing as they go through the grieving process.

“We never keep to the present… We anticipate the future as if we found it too slow in coming and were trying to hurry it up, or we recall the past as if to stay its too rapid flight. We are so unwise that we wander about in times that do not belong to us, and do not think of the only one that does; so vain that we dream of times that are not and blindly flee the only one that is.” (Blaise Pascal, Pensees, 1659)

I know that it may sound simplistic, even trite, to suggest the importance of living in the present moment—but it is true. The regrets of the past and the fears of the future are the primary culprits that take us from the gift of the present. And—if you will allow me a little oversimplification, regrets and living in the past fuel depression and fears and living in the future fuel anxiety. So… it does make intuitive sense that inhabiting the present moment is of great value to our wellbeing. The challenge, which most of us don’t readily appreciate, is that if you want to improve your ability to attend to the here and now—then you will need to practice!

Jon Kabat-Zinn suggests that “mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” You can understand, then, how meditation is simply an optimal way to practice—paying attention with intention and lovingkindness to one’s breath, one’s thoughts, one’s body, sounds in the environment, a candle or a sunset, the taste of blueberries, the aroma of fresh baked bread, etc.… you get the idea.

It would be wise to take some time each day in a formal way—five to ten minutes is a good start (research has shown that consistency is more effective than lengthy times if they are sporadic); however, you can then augment your practice when you have a few minutes waiting for someone, two to three minutes at work for a mini-break, turning off the television and staying in your chair, etc…. you get the idea.

When you practice, you are more likely to know when you are not in the present moment so that you can gently return to the present moment—even under stressful conditions (when we are conditioned to return to the past or tempted to reach for the future). So… in closing, here are a few nuggets to consider:

Be gentle with yourself: nonjudgmental = self-compassion.

When you catch yourself straining, know that you are not on the path of mindfulness.

Accept the things you cannot control, including your thoughts—but remember you can make choices (including the observation of and the response to your thoughts).

By Sarah McElhaney, L.M.F.T., licensed marriage and family therapist at the Des Moines Pastoral Counseling Center

February 2017 – The relationship with your partner could be one of the most important in your life, yet it is too easy to forget how vital it is to nurture the relationship daily. In the season of hearts and roses as symbols of love, I’d like to offer the following practical tips on how couples may improve their relationship, and overall quality of life:

Know your partner’s inner world. Regularly make time with your partner to tune into one another exploring and learning more about each other – from the big stuff like their hopes, dreams, and current goals to the details that make them unique – like their likes and dislikes. Make time, get generally curious, and ask open-ended questions.

Promote a positive relationship culture. Good relationships have a ratio of 5:1 positive to negative interactions (contrasted with almost 1:1 in struggling relationships). Point out what your partner is doing right and focus on expressing appreciation, fondness, affection, and respect regularly and in small, everyday moments.

Be available and responsive. Being consistently available and responsive to one another and each other’s needs creates a sense trust and an emotional safety net that can be helpful when weathering times of stress. It answers our most basic underlying needs for connection, “Are you there for me? Do I matter?”

Manage conflict calmly and effectively. Conflict is inevitable in relationships. And in couple relationships, 69 percent of problems are “perpetual” problems that are often “unsolvable.” Couples that do well at managing conflict address these areas calmly, have conversations about them that often does not focus on “solving the problem” but rather accepting each other’s influence and positions.

Recognize the early signs of relationship distress and seek guidance early. The research is clear — couples generally tend to wait too long before seeking couples therapy (on average an entire six years from when they first began noticing problems), but two of the most important factors for couples doing well in therapy is their motivation level and timing.

June 2016 – Did you know cardiovascular disease may trigger depression? Counseling and medication can help. When someone has a heart attack, heart surgery or stroke, the immediate concern is addressing his or her physical health. Once down the road to physical recovery, it’s also important to monitor mental health. If you or a loved one have experienced a cardiac event or diagnosis, and are having difficulty regaining the zest for previous life interests (such as hobbies or relationships,) you may wish to ask your doctor for a referral to a qualified mental health professional.